Dr. Jessica Drummond 0:03

Fortunately, in the last two years that we've been doing this program, we've been working kind of in a holistic model with endometriosis for about 10 years now. I'm really seeing more and more 16 1718 year old girls coming into my clinic with their moms and their moms are often like, Oh, yeah, you know, I have this or aunt so and so has this or my mother probably had it or I think I had it, but I was undiagnosed. There's definitely an improvement in awareness in the last five years, and we are seeing younger and younger patients. So I think that's a really important thing because earlier treatment saves women years of symptoms, but it also is fertility preserving, which is really important.

Dr. Stephanie Gray 0:50

Welcome to the longevity blueprint podcast, I'm your host, Dr. Stephanie gray. My number one goal with the show is to help you discover your personalized plan to build your dream health and live a longer, happier, truly healthier life. You're about to hear from Dr. Jessica Drummond, who is a physical therapist to incorporate so much more than physical therapy into her clinical practice. Today, she's going to talk about endometriosis and pelvic pain, and we're gonna dive deep into some concepts you may not have even thought would relate, like the importance of improving vagal tone, targeted supplements nutrition and detoxing the body supporting limp. So let's get into the episode.

Thanks for joining me for another episode of the longevity blueprint podcast. Today I have Dr. Jessica Drummond on is my guest who is the CEO of the integrative Women's Health Institute and author of outsmart endometriosis. She holds licenses and physical therapy and Clinical Nutrition and as a Board Certified health coach. She has 20 years of experience working with women with chronic pelvic pain, facilitating educational programs for women's health professionals in more than 60 countries globally and leads the virtual wellness programs for people with endometriosis. Dr. Drummond lives and works with her husband and daughters between houston texas and Fairfield, Connecticut. So thank you for being on the show, Dr. Drummond.

Dr. Jessica Drummond 2:11

Thanks so much for having me. It's my pleasure to be here.

Dr. Stephanie Gray 2:13

Why I've been excited to talk to you. As I mentioned before we started recording because I have had stage four endometriosis myself and struggled with terrible painful cycles. For years. I have no pain with my cycles now, which is amazing. And it's reflecting back like, man, is this what the majority of women experienced no pain, what their cycles like I lost 2030 years of my life, not 20 years of my life, but things so I'm excited to share what you have with the listeners because you're an expert in this area. So let's start with just telling us how your career progressed towards working with people with pelvic pain and endometriosis.

Dr. Jessica Drummond 2:51

Sure, so I graduated from physical therapy school back in 1999. And I was an athlete, I was a kid who liked science. So sort of like the natural progression was to go into something healthcare related. And so I went into physical therapy expecting that I would focus my career in orthopedics and sports medicine, but once I started practicing, pretty quickly, like within the first three years, I began to specialize my practice in women's health, which, you know, is from a physical therapy standpoint, is just specialized orthopedics really, you know, I would work with women who had had breast cancer surgery and had shoulder issues or pregnancy related back pain or you know, if I kind of carry around my trusty pelvis, if you if you know, these are your hip bones, and here's your spine and tailbone, you know, the floor of the pelvis, which is, you know, we're talking about bladder and bowel and bladder and sexual health, vaginal, that all revolves. It's all supported by muscles and joints and nerves and circulation.

And so I began to specialize in in that kind of general perspective on using my orthopedic background to address concerns that are most commonly in women. You know, endometriosis is primarily in women but can be in transgender men, of course and, and so, over the years, the most challenging population of patients that I would work with were women who had chronic pelvic pain conditions, things like endometriosis, interstitial cystitis, painful bladder syndrome, vulvodynia, vulva and sexual pain and things like you know ovarian pain pcls, things like that. And sometimes more than one of these you know, as you know, having experienced this yourself, often these various kinds of pelvic and sexual pain present together and so when I first saw started working in this area and probably for the first five years of my practice, it was very difficult to get any kind of diagnosis, the surgeries were terrible, actually, first 10 years really the surgeries that my patients had access to, you know, they would come and having, I've had 17 surgeries I've had, you know, and because they're, you know, the skill, the kind of surgery they were having the people weren't really trained in certain the right kinds of surgery. Also, we didn't have a lot of useful tools, the medications didn't work that well, they didn't work consistently.

They had a lot of side effects, it's still really the same thing. Now the delay to diagnosis was an average of 15 years. Wow, it's still bad. It's an average of six to 12 years, but it's improving at least which is, I suppose, something to be said for that. So I realized, you know, I realized that the tools that I had in physical therapy were helpful, but would often leave my client sort of plateaued. And that was also related to our skill set generally, in physical therapy to a lot of people with endometriosis have a cold hernias have nerve issues, you know, things that we weren't really looking for in 2004, you know, so the all the whole field has progressed. But the thing that I think brought me specifically full circle in this working and continues to expand is starting to bring a holistic perspective and include nutrition from a functional medicine perspective. After the birth of my first daughter, I had a kind of a hormonal clack crash related to a viral reactivation and a lot of fatigue, anxiety, very vague symptoms, just like people with you know, these chronic pain, invisible illnesses experience for a long time. And the tool that was most helpful to me personally and was really helpful to my hormonal health, including a secondary infertility struggle was nutrition. So I went back to school and got a doctorate in nutrition and began to integrate the physical medicine, mindset, wit and more kind of Western mindset, with a more integrative and expansive holistic mindset thinking about stressors and childhood trauma and birth trauma, and all of that kind of bringing a wider perspective on dealing with pain in general, but specifically public and sexual pain since that's really was my clinical area.

Dr. Stephanie Gray 7:48

So let's specifically get into endometriosis and maybe even pelvic pain. Can you speak to how common those are?

Dr. Jessica Drummond 7:56

Yeah, pelvic pain is extremely common. You know, I think something like 80% of women. So you said earlier, like, most women feel great during their periods. That's not exactly, you know, between period pain, vaginal pain, sexual pain, bladder pain. If we add all of those things up postpartum sexual pain, it's very, very common to at some point in your childbearing years have some sort of pelvic pain, some somewhere in the 80%. And endometriosis is also very common, not nearly that common, it's 10% of women have endometriosis, which is still alive. You know, that's two girls out of every class of 20 teenagers, you know, which is a lot and it's not screened for yet by our school nurses. Although our organization does support and another organization called endo what that's doing a really good job of trying to educate school nurses around the world to start screening for this because endometriosis is the number one reason that middle school and high school girls miss school. So it's actually quite common, but it's not very well managed.

Dr. Stephanie Gray 9:10

So what are symptoms specifically of endometriosis? So to viewers who maybe have never heard this term before, we've alluded to painful cycles, what are other symptoms of endometriosis?

Dr. Jessica Drummond 9:22

So, painful cycles are key, always cyclical, especially in teenagers because usually the symptoms begin. And Demetrius is an underpinning of a genetic disease. So even studies done in female embryos show about 9% have endometriosis. So it's a there's a genetic disease that sort of activated at puberty and by inflammation and you know, things like that. So a normal timeline or common timeline is that girl you know, between like eight and 12 We'll start experiencing like chronic stomach aches, bloating, constipation, IBS, things like that. All the GI workup is done, they don't really find anything or they do and they treat it but it comes back, you know, that kind of a picture. Then when they get their period, or a little before or sometime in those first few years, there is debilitating sort of cramping pain, which can be pretty cyclical, it can be more random, especially at first, especially in teenagers, because of course, the cycles are still pretty random. Some people have no symptoms at all. And Demetrius is can be silent until later, women may struggle with infertility.

So it's it's that kind of combination of symptoms, I often see women with overlying anxiety, depression, a lot of fatigue, the side effects of some of the medications that are used to just sort of quiet the symptoms like hormonal birth control or pain medications, or antidepressants tend to have like fatigue, brain fog, anxiety, depression, kinds of secondary effects, for sleeping, things like that. So it can be any number of things in that realm. And for some people, the pain is very severe. And for some people, it's not as to fear some people, it's only with sex, some people told me at the beginning of the period, some people it's bowel movements, some people it's more all the time or can be triggered by anything. And then for some women, the symptoms are much more mild. The challenging thing about endometriosis is that we don't have an easy diagnostic tool. So you have to have a laparoscopic surgery, to have it ruled in or ruled out. And, you know, it's not like a simple blood test. So unfortunately, that leaves kind of the, the combination of what various symptoms can present also could look like a lot of other things, digestive issues, you know, psychosocial issues and so forth. But it tends to be some combination of those symptoms. And it's not indicative like you said, Do you have stage had stage four endo, which is pretty, which is the severest form, you could have very severe symptoms and only have only have stage one, endo, right, you may not have symptoms at all, or very few and I have stage three or four. So it's not indicative of the severity of the disease the presentation either which is confused, frustrated

Dr. Stephanie Gray 12:45

and confused. So you mentioned you correct me if I'm wrong you work with or you? Maybe this is your organization that's supporting, advocating for nurses to are you saying screen for these symptoms so that this can be detected at an earlier age. So the deleted diagnosis isn't as long?

Dr. Jessica Drummond 13:06

Correct. So it's not my organization. The organization is called endo. What? They have also produced a film a movie explaining more about what I know is, and now they have what's called the school nurse and nurse initiative, which educates school nurses to yes be the kind of eyes and ears on the ground of when this is most commonly beginning to present. rather than waiting till women are in there, you know, as you said, like it can take 20 years of chronic pain before someone's like, oh, maybe you have endo. Right. So that organization, our my company, the integrated women's health is to, you know, does some funding with them. But that organization runs that initiative. And I strongly advocate for that because I think, you know, a fortunately, in the last two years that we've been doing this program, we've been working kind of in a holistic model with endometriosis for about 10 years now. In the last two years, I'm really seeing more and more 16 1718 year old girls coming into my clinic, you know, with their moms and their moms are often like oh yeah, you know, I have this or aunt so and so has this or my mother probably had it or I think I had it but I was undiagnosed. There's a definitely an improvement in awareness in the last five years. And we are seeing younger and younger patients. So I think that's a really important thing because earlier treatment saves women years of symptoms, but it also is fertility preserving is really important.

Dr. Stephanie Gray 14:45

Absolutely. And that's what I struggled with infertility, and we just partially met a good suspicion that I had endometriosis based on the severity of my symptoms, but that's when I really did need to get my scope and diagnosis. So let's let's talk about conventional deconversion approach to treating endometriosis in a little more detail. And then I want to talk about natural therapies for endometriosis. So what are the conventional treatments? And I guess let's back up even further. Let's talk more about the laparoscopy exactly what that is. What that procedure is to determine if a patient has endometriosis and then talk about some conventional treatment options.

Dr. Jessica Drummond 15:24

Right. So laparoscopy is a kind of robot driven camera surgery, where the excision so excision means like cutting out of the Legion, sort of at the root. So the old the other version of endo surgery is called ablation where there's like a laser that just burns off the top of you imagine a lesion on a you know, an organ system or whatever. And then there are some roots to it sort of like a cancerous tumor. And it was not cancer, although it does predisposed to some cancers. But imagine if you have a tumor growing into something you would want to ultimately what's called exercise out that whole lesion. ablation when my patients were having 1617 surgeries you would go in it's the good thing about laparoscopic surgery is it's smaller incisions. So there's a camera in internally, and then the tool that either burns off the lesion at the top or cuts it out excising that's a very oversimplified explanation, but I'm not a surgeon. So hopefully that will do. But, you know, the, like, one of the the surgeons I know quite well, who does really skilled excision surgery, he used to be a military helicopter pilot. So like, it's literally like you're kind of driving these various arms, which is a combination of a camera and a tool to excise. Yeah, so you have to drive the camera so that you can see what you're looking at on a screen through some smaller incisions rather than just cutting the person's entire abdomen open, which is a much easier recovery than a no. Yeah. But there has to be some sort of blind skill, which is why that sort of history of helicopter, though, is a benefit.

Dr. Stephanie Gray 17:24

Many surgeons have that experience, but that's right. But I think it's a useful visual of life, to be kind of driving a number of instruments, and then using a screen to be able to see it. So that's the laparoscopic both diagnosis and surgical intervention to remove essentially the abnormal growth, right. So endometriosis is this abnormal growth of tissue, it's inflammatory, that can hinder implantation of an embryo right, causing infertility, that can cause pain. So those lesions need to be removed, we need to get at the root cause as far as why the patient had endometriosis. So it doesn't come back. But yes, removing the lesions is key. And I mentioned in my book, Your longevity blueprint, I mentioned a patient who had had the surgery you mentioned, that was more of the ablative therapy where the lesions were burnt off. And guess what a few years later she had it again.

And again, I patients come to me saying I've had the surgery 11 times and I'm thinking surely, surely we've technology has progressed to the point where we don't need to keep doing the same surgery, that's not working. But sadly, the recurrence rate with endometriosis is very high with those when you only have those sort of surgeries. And so I knew in my journey, I did not want that surgery, I wanted the excision surgery, however we call it where they literally will cut out the entire lesions. And the surgeon that I sought out in another state also had a non scarring technique, they use a non scarring solution because many patients end up with more scar tissue after the surgeries that lead to more pain. And I knew that I didn't want that. So I feel very fortunate for knowing what I didn't want. Yeah, I had to seek out someone outside my state to do the surgery that I that I needed to have. So surgery is one option. Before before surgery, many patients are as you mentioned previously recommended birth control. Also right, which we know can cause more harm than good. Do you want to speak to that a little bit?

Dr. Jessica Drummond 19:24

Yeah. So So finding, I think there's a couple key points. I just want to highlight real quick about surgical. Yeah, finding a surgeon who's really skilled at this makes a huge difference. Like that's probably one of the most important things you can do. The challenge of that is that it's usually quite expensive. It's not available everywhere. Yet many of these surgeons are more of a cash based practice, because unfortunately the reimbursement is not good. Most of the surgeons who are working on this are trying to improve that through a company And everything in the US and it depends on what country you live in sure the resources, but there are resources, you can certainly come You know, seek me out on Instagram and we can help you find all those resources and I'm sure you have some as well. But finding the right person who's very skilled with that surgery makes a big difference to the outcome because yes, how skilled they are with the surgery, the surgical technique, they use the fact that they consider more complexities like the post op adhesions and scarring bowel function, you know, all of that matters because we're endometriosis grows, it's not just a sexual disease, right? We think of this as like a women's sexual disease. Now, endometriosis is a lesion of tissue and there are various kinds that can grow anywhere women have their case studies published of people having endometriosis in their nose, me, wow, a crumb. You know, it's not just on the uterus, it's

Dr. Stephanie Gray 20:59

all over the bladder or the bowel. Yeah,

Dr. Jessica Drummond 21:01

yeah. It's often on the bladder bowel or around the uterus. By definition, it's external to the uterus. So it's not really in the uterus, but can be on the ovary, it can be on the fallopian tube, identify ISIS, which is kind of a sister condition is having a similar kinds of lesions on the on the muscle of the uterus. So, bottom line, you need to find, you know, a skilled surgeon to at least consult with understand the diagnosis now,

Dr. Stephanie Gray 21:27

absolutely.

Dr. Jessica Drummond 21:28

surrounding that the conventional therapies up to this point have been basically two things, pain medicine, pain management, which is a problem because you know, we have a huge opioid addiction issue in the US and up until very recently, that was one of the number one tools it's just like massive pain right? Now, it's much less so because opioids are so much more heavily regulated, but for you know, the first 17 years of my practice, it was really common, and so you have a lot of opioid addiction. Second would be more of like, pain, neuro modulators. So things like Gabba, Penton, Lyrica, you know, these have some usefulness and validity. There are some good studies, they do sort of down regulate the nervous system, there is some kind of kind of brain neurotransmitter support. If you kind of just again, take a big giant step back and look at the data and look at it in practice. You know, I've heard it summarized as 30% of the patients 30% of the time, feel some kind of benefit with it.

And I think that's probably pretty reasonable, given my clinical experience, and sometimes it can be really helpful to downregulating, the nervous system post preoperatively. And in that additional than the original initial post op timeframe, because surgery is by definition, going to amp up the nervous system. So if we can keep that as chilled as possible, and some of those tools are helpful, that's valuable. The other perspective was like suppressed hormones. This is an estrogen driven disease, and we just have to turn off the estrogen. Well, there's a lot of problems with that. It's not always estrogen driven. Newer studies that have come out in 2018. Look, have seen for histology upregulation of progesterone receptors on endometriosis upregulation of both estrogen and progesterone receptors on endo lesions, no upregulation of either receptor on the lesion. And in the same woman, you could have upregulated, estrogen upregulated, progesterone, both neither on a variety of the different lesions she might present with. So it's not as cut and dry to just suppress estrogen, which is what a lot of them drugs do, including hormonal birth control, basically, is a hormonal suppressant. Which again, is why sometimes it's like, oh, it's a miracle. My symptoms are gone when I'm on her hormonal birth control, and other women are like,

feels the same, maybe worse on this. So there's not a straightforward answer to kind of the underlying causes, and it does vary. So the medications are not a homerun at all. So from a nutritional kind of integrative standpoint, ideally, we see our clients in a four month program and ideally about three months prior to surgery. If they're going to have surgery, not everyone needs surgery, and not everyone wants to have surgery either way, and that's totally fine. And then you know if they have surgery about a month post op and then sometimes we repeat that program a couple of times depending on various things, it can take a while to completely root cause recover. And sometimes women then want to try to get pregnant or want us to support them through the process. So, the outcome varies but let's assume kind of that initial four months of optimizing their system so that they can either have surgery or they don't need surgery or they choose not to have surgery.

So the systems approach that we take optimizes kind of nervous system calming first, because the most the most The more we can kind of down regulate the nervous system with Vegas Vegas nerve toning, heart rate variability optimization, breath work working with pelvic floor physical therapists to kind of you know, calm and move the pelvic floor so people aren't walking around with like a lot of muscle tension, limb flow, you know circulatory system optimization, that then helps the next layer which is digestive system digest. So many women have CBOE and CFO or like bloating, overgrowth of bacteria, constipation, diarrhea, both so getting the digestive function optimized eating a very anti inflammatory food plan, adding nutrient dense vegetables and easier to digest foods, blended soups, Foods high end culinary herbs and spices like oregano and tumeric. tumeric has like about nine different mechanisms that it helps endometriosis, optimizing digestive function, shooing stomach acid, digestive enzymes, and then the immune system is about 80% tied up in the digestive system. So the more we optimize digestion, the more we can then optimize immune function and then we can more specifically support that with mineral absorption and you know calming things like histamine, excessive responses, some of these people with an endo also have like hives issues or bladder pain that can or skin issues that can be related to more of a histamine sensitivity, and then excretion detoxification.

So hopefully, we're first getting someone pooping really well and easily and normally, motility can be a big issue in endo, because a lot of times the lesions are right growing on the intestines and or there's some scarring or adhesions related to that. So gut motility can slow down. So you want to get that optimized, and then also supporting the liver with things like broccoli and other cruciferous vegetables, lots of leafy greens. So we have a lot of tools between nervous system, kind of toning and strengthening circadian rhythm alignment to help with that anxiety and fatigue, movement practices. And then nutrition and some targeted supplementation really puts the body in a healthier foundation so that whether or not someone chooses to have surgery, when they come out of surgery, they're in better shape, and then they're prepared to just live their life get pregnant fertility improves that first year post optim operatively, probably because of some immune factors, we can enhance those nutritionally. And so that's really the approach that we've developed over the last decade or so.

Dr. Stephanie Gray 28:21

I love that I'm taking notes here because I want to come back to some of those points. So can you give the audience of listeners a few strategies for improving vagal tone? So what are some of your top favorites?

Dr. Jessica Drummond 28:33

Cold water swimming is great if you live near like, I live on the sound. This is like I live in Connecticut on the coast. So it's pretty cold in the wet that water most of the time.

Dr. Stephanie Gray 28:46

So you can easily swimming so not just like a dip you're saying swimming? Well, you say five

Dr. Jessica Drummond 28:52

I cold water immersion, it really takes to optimize the vagus nerve, five minutes a day. So if you could take a five minute cold shower, that works, but you could also jump in your local lake or ocean if it's pretty cold. You know, and it doesn't have to be a long swim, but a minute to five minutes is helpful. Cold water immersion. I like loud singing works pretty well. The vagus nerve runs right by the throat. So anything that will like vibrate, the throat will work so you can use loud singing you can use like chanting if you're into certain kinds of yoga or meditation. My slow breathing also works diaphragmatic breathing or just paced breathing, which is just like four breaths in four breaths out. That helps intense gargling will do the same thing because of the location of the vagus nerve. Sure,

Dr. Stephanie Gray 29:48

those are great. Again, just so the listeners understand how important this is. We want to calm the nervous system down also because stress is a big hormone hijacker and hormones aren't bad. I do find in many of my patients, I think it's interesting that you mentioned, some studies have shown that projects are that endometriosis could be progesterone driven. But I will say in most of my cases, my patients with endometriosis are very estrogen dominant, they are very low on progesterone, and stress. I say this all the time, stressful Rob, you have progesterone, soothing, calming hormone. But that's great for calming cramps and helping, usually helping pelvic pain, minimizing a lot of those nasty symptoms. So in a way, singing loudly and doing these cold baths could improve your hormone status, to minimize the painful cycles. I just want to try to kind of tie that together. Also, of course, you want your body to be in a more relaxed state to relax the pelvic floor. Also, I'm sure but I just wanted to make that connection. So the listeners know why. Why am I singing loudly? Or what's the point of me doing?

Dr. Jessica Drummond 30:55

Yeah, it's very true, calm nervous system is key to hormonal balance. Because one, you can't absorb fats, which build all hormones unless you have a calm environment for optimal digestion. good tip. But also, if your cortisol levels are imbalanced, which is why stress is such a huge factor, then that is he said, sort of robs you of your progesterone. And and actually any hormones can be able to have any reproductive hormones can be thrown out of balance. Yeah. So that stress balance is probably one of the most important things we can do, which is why we've just recently started including heart rate variability tracking, because that's a very objective measure of stress that you can use. There's so many like, you know, you can, using a watch, passively track that and start to just notice, huh, when I eat chocolate ice cream, my HRV goes up or when I'm with my boss, Jeremy not goes up. But yeah, it goes awry. My stress goes awry. Our heart rate variability should increase but like the way it's tracked in the app, you'll see a calmer, you know, huh? Was I after that three, five minute cold shower? Was it more in the calm? And I think the more we can start to use things that are passing tracking, it's very difficult, from a behavioral standpoint for people to actively track things like stress, but to start passively tracking, an objective measure of stress has something we started to look at more seriously because I think it's so valuable to see how impactful stress really is.

Dr. Stephanie Gray 32:43

I love that love that you start with your all your clients. What's that is number one. You may have heard me mention the nutrient dim on several episodes and I want to take a moment to describe exactly what that is. When I was in graduate school, my doctorate focused on estrogen metabolism. Now, you're probably wondering what that even means and why it matters to your health. Well, research has shown that our risks for fibroids cysts and breast ovarian, uterine, prostate and colon cancer can all be linked back to estrogen. But it's not the levels of estrogens that can increase our risk. Instead, it's the way our bodies handle that estrogen that matters. We can run individual lab tests for this which I often recommend to my patients that's called estrogen metabolism testing, which has to be done in the urine. Even without the test however, it is safe to take a supplement an extract of cruciferous vegetables to improve your estrogen metabolism. That's basically like taking in six pounds of those veggies per day in a capsule form without the gaps. That supplement is called dim di m you can also use methylated B vitamins as well as specific targeted antioxidants like resveratrol to help improve your estrogen metabolism and help protect you from that cancer risk. Of course, also make sure you have your practitioner run a comprehensive genetic analysis to see from another perspective, if you are at increased risk and help you learn what you can do to lower that. If you're interested in learning more about dim, read chapter six of my book your longevity blueprint and check out our product info sheet at your longevity blueprint.com Ford slash product Ford slash dim to get 10% off Tim alone or 15% off our estrogen detox bundle with dem methylated B vitamins and antioxidant support. Just use the code estrogen detox when checking out at your longevity blueprint calm. Now let's get back to the show.

Let's talk about what you consider an anti inflammatory diet. So this was huge for me also. So let's speak to that a little bit.

Dr. Jessica Drummond 34:44

So there's no kind of one size fits all no diet because it depends on your genetics and a number of other factors. We do two tests really commonly we look at gi the gut microbiome and we look at absorption of nutrients And so there are genetic factors which make sometimes or n factors related to those two lab tests that make certain anti inflammatory diets better than others for different people. But the core of it is mostly plant based foods. And then things that are less inflammatory we either take out or minimize depending on the circumstance, sugar, gluten, dairy, soy, and alcohol usually are the kind of main ones that would cover most people. Some people need a quite plant based diet that's less common in my experience, more common would be in the direction of more paleo, occasionally ketogenic diet, occasional intermittent fasting can be beneficial or eating in that kind of making sure there's a 12 hour window at night of not eating with sometimes pumping that up to 16 hour window. So basically, you're eating between 11 and seven, because that's so supportive to the immune system. But, you know, animal based proteins tend I find that my patients do better who can tolerate some animal proteins, fish, organic poultry, grass fed beef, things like that. It doesn't have to be every day, it doesn't have to be every meal. But because, you know, we need so much protein to heal in this condition. I just find that it works better than going completely plant based. But you still want to be plant dominant, you know, and not a lot of raw vegetables at first, because the digestive function is usually off. So blended soups, you know, smoothies can be really helpful, things like that, we have to be mindful of making things easier to digest. Sure,

Dr. Stephanie Gray 37:02

I had been gluten free. I don't know how many years, five years whatnot. But before I struggled with infertility, and I was actually very pleased that my surgeon recommended an anti inflammatory diet, and she said, You need to be dairy free. And I said, well, but dairy didn't show up on my food sensitivity test. It had years prior, and I wasn't consuming that much of it anyways, but I had after my surgery, I still wasn't getting pregnant, I needed to go 100% dairy free, and six months later, I was able to get pregnant. So I think going dairy free was a huge part of my journey, also, and just so the audience makes the connection. Dairy many times will feed estrogen dominance, right? Because we're eating cows that are injected with hopefully you're eating organic dairy if you're eating any, but you're consuming the milk from the cow that's been injected with hormones, potentially growth hormones, right? And estrogen is a proliferative hormone, it will cause growth of tissue, right? That that causes your uterine lining to thicken. That's why you have a period. So what do we do want to minimize foods that are going to feed estrogen like the soy that you mentioned and the dairy whatnot, so I i absolutely can appreciate that. You alluded to some targeted nutritional supplements, so maybe mentioned a few of your favorites that you use on these cases. You mentioned turmeric actually already?

Dr. Jessica Drummond 38:17

Yeah. tumeric is a great one. Probably the most diverse research on that. So I like that in many cases. And if someone can't tolerate super high doses of tumeric, you know, coconut milk curries are great golden milk lattes are great things

Dr. Stephanie Gray 38:33

like that have a dose to use what are you recommending?

Dr. Jessica Drummond 38:36

You can use you know for study doses up to 2000 milligrams for you know, things like depression, because if someone has a you know, imbalances in the bowel, you know, I think 500 to 2000 milligrams is reasonable on this population when there's a lot of inflammation, then I really like fish oil. So for period pain, they did a horrible study that was just like, I'm like could even control this any worse. But without even checking on anything. They gave all these women 1000 milligrams of fish oil a day. And the period pain was dramatically improved for any reason there was no underlying diagnosis there was no looking at is someone you know, omega three deficient, I just gave everybody thousand milligrams of fish oil and it was helpful. So usually I go a little higher in this population more like 3000 milligrams a journey and maybe even a little bit more short term. And being a little bit mindful of when the surgery is although I talked to one of the researchers who's done some of the most efficient oil, omega three fatty acid research, even in brain injury in the military. And he was not concerned at all that being like a bleeding risk. So I'm much less concerned about that than I used to be. But I am mindful of that pre op and post op that we just want to make sure we don't get rejected. Some bleeding.

Dr. Stephanie Gray 40:00

Sure. I will say I do some procedures in my office and absolutely my patients on high dose Fishel believe more and they absolutely do we have to hold pressure. Yeah. So many times and it could vary based on the patient and their genes to like so, but I do usually recommend patients just in case they're going to be more of a bleeder. Stop ahead of time. The official box a Coxon box enzymes like ibuprofen would right? So instead of taking ibuprofen, which I took for years and years and years, for my endometriosis pain that I didn't know was endometriosis. At the time, destroying my gut, which then led to CBOE and fructose intolerance, and likely all my food sensitivities, whatnot. Instead of taking ibuprofen, you could take fish oil and turmeric. But I didn't know that. Yeah, as in as that as a teenager, I didn't know that I didn't have those tools. So if you're listening and your mother and your daughter has painful cycles, these are great tips. Turmeric and fish oil are a great place to start along with the diet changes in the stress reduction. Yeah,

Dr. Jessica Drummond 41:00

but those are probably my two most kind of direct supplements. I also really like digestive enzymes and sometimes obtain HCl like we have to help the digestive system do its job. Sure. And then sometimes specific probiotics and or anti microbials, depending on what we see and a little bit more granular data but that I would do more in a more personalized way. But I think as you said turmeric and fish oil, you really can't go wrong and if you don't want to take them as supplements, eat more curry golden milk latte eat 12 to 16 ounces of quality fish. You know we can get this in food too.

Dr. Stephanie Gray 41:36

Yeah, that's great. What about dim Do you use dim in your patient population?

Dr. Jessica Drummond 41:41

I do dim broccoli extracts, sulforaphane, things like that. Yeah, I think liver support is really valuable. And even things like you know, castor oil packs, dry brushing, you know, get the whole lymph and detoxification system breath work. You know, it doesn't have to be all about the liver. But absolutely. And I think being mindful of environmental estrogens, because I had one patient we could not get rid of her period pain. She was living in the Middle East. And I was like, you know, it's really hot there. Do you ever wear plastic flip flops because she had her take change all her makeup, stopped drinking out of plastic water bottles wasn't storing food in plastic. But sure enough, until she stopped wearing hot plastic flip flops every day, we couldn't get her estrogen controlled. So that's another thing to think about not just supporting the deliver but lowering the toxic load.

Dr. Stephanie Gray 42:40

Wow, who would have Who would have thought? I know did thankfully. So yeah, all those those last tips support, detox so even dam will help clear out excess estrogen, which is wonderful. Can you speak to castor oil packs, I haven't had anyone on the podcast yet mentioned how to use those Can you.

Dr. Jessica Drummond 42:59

So the naturopath that we work with in our clinic does that more than me, but basically you just take castor oil and you you put it on a warm flannel cloth, and you can put it on the abdomen. If you're having trouble kind of moving the lymph in your neck for some reason, you can even gently put it over the neck. Interesting. In the last few weeks, we've had a number of patients who have both tight pelvic floor and kind of tight throat issues like they get scratchy throat, they can't talk for too long things like that. They have kind of chronic and they feel like they can't swallow pills because their throat feels tense. There's some kind of interesting connection between the throat and the pelvic floor that I don't know if we have any research on but just kind of clinically, we've started to notice that more and more and so she one of the things she recommended that I really think is a great idea is kind of taking that castor oil support detox, which, at worst, it just feels good, right? You put a warm pack on your abdomen, have some castor oil, leave it on there for you know, 1520 minutes and it's supportive of limp flow. Physical Therapists also do manual massage, you can use dry brushing, but I think we underestimate the support of the circulatory and lymph systems to help with detox. Yeah, you know when we're supporting all the detox organs.

Dr. Stephanie Gray 44:27

Great, great tips. I know we focused a lot on endometriosis but since you are a physical therapist, I do want to come back to pelvic pain real quick. And obviously endometriosis can be a cause of pelvic pain. You mentioned trauma like childhood trauma can can lead to to pelvic pain. So in the few minutes we have left here. Do you want to talk just a little bit about other contributors to pelvic plank televic pain that you have found and then some strategies to help patients recover from those?

Dr. Jessica Drummond 44:56

Yeah, I mean, I think in childhood what are called adverse childhood events, which are essentially traumas in childhood but can also be in the teen years could also be, you know, if we want to get a little esoteric, when your mother was pregnant with you if there was some kind of trauma going on there, sure. childhood trauma, childhood trauma, teen trauma, birth trauma, anytime you're in more of a vulnerable situation, and there's a traumatic experience, there definitely is a kind of lowering the resilience of our stress buffering system. And that can be hard to completely turn around. So trauma informed psychotherapy, trauma informed physical therapy, being just gentle with your own stress responses, knowing that you're going to need more recovery, knowing that, you know, you want to unwind that trauma as much as you can.

But you also have to really be gentle with yourself, because it's a long term effect, to having traumas during any of those vulnerable lifetimes that shifts the ability of the body's system to buffer any subsequent trauma traumas. So I think it's just something that is under appreciated. And I think, you know, the system itself breeds trauma around this specific disease process, you know, anything pelvic pain related, can take years to be diagnosed is often dismissed by doctors, oh, you're having sexual pain, just go have a glass of wine first, you know, are like, Oh, you know, it's normal during delivery, blah, blah, blah, you know, there's a lot of kind of, under appreciation of how much trauma women go through, and how little they really know about what's going on during a lot of these situations. And instead of our system, allowing the time and space and training of providers to really slow down and explain and support, there's a lot of, Oh, my gosh, this is an emergency, we're going to do this to you. And then like everyone leaves. So or it's like, oh, it's not that bad. Or you're just everyone has period pain, or it's normal, you know, and it can even be in families, especially around endometriosis, because there is some, you know, generations to generations, like, every woman in this family has bad periods, and welcome to the club. But there's a lot of trauma to not being believed and our system is is really set up that way for women in general, but about five times worse for women of color. So I think we just have to be really mindful that many of these situations, by the time someone is addressing it appropriately, there are layers of trauma that need to be considered and that does directly contribute to the physical pain. So managing the trauma is all as as important as taking tumeric.

Dr. Stephanie Gray 48:00

Yeah, good, good. I know postpartum is a very traumatic delivery, we won't get into all of that. But my postpartum I knew primarily from preventing urinary incontinence standpoint, incontinence standpoint, I wanted to see a physical therapist because I wanted to make sure I was strengthening my pelvic floor appropriately and doing the right exercises and whatnot. Right. And I and so I went to an amazing physical therapist, and she taught me that I might fill the floor was pretty tight. And so I really did need to just learn how to relax the pelvic floor, do you When patients come to see you is very common that these patients with this pain, I mean, their pelvic floor is just very tense and tight? And you really have to work with them? through multiple ways to relax? Yeah,

Dr. Jessica Drummond 48:44

yeah. And of course, the bias is strengthen, strengthen cables, you know. But even when people have prolapses, or incontinence, a lot of times they're kind of gripping, because they're trying not to pee, or they feel like something's falling out. Sure. So we have to retrain. And you know, until you've had a baby, and sometimes even three years after, never do we really like get educated on connecting our brain to the muscles of the pelvic floor. So a lot of this is done sort of in an involuntary protective way. So re education of those muscles to both relax and move is really important. So if I walked around for the last eight years with my elbow bend, trying not to, you know, pee out of my black bicep, it would be very difficult to strengthen it from this position, you can't like just squeeze it harder. So you have to learn to lengthen and relax and have strength kind of all along the way, right at every different angle, not just way up here. So there's there's the same thing with the pelvic floor, can it move and can it be strong in every range? And you know, we don't have automatic pelvic floor physical therapy postpartum like they do in many European countries. So we really need to self advocate that, you know, there are people that can help you just in the last couple weeks, I've seen two friends who, you know, months postpartum were like, I think there's something wrong, I don't know. And I was like, Alright, you know, I'm just gonna come look. So everything's close, and

Dr. Stephanie Gray 50:18

I'll just gear up and just come to your house.

Dr. Jessica Drummond 50:20

And they both had pretty severe vaginal wall prolapses. And their doctors was like, Yeah, you're fine, go back to sex, go back to running, go back to strength training, you know, you, we don't get any good recovery for this stuff. And then it just pushes the problems down the road.

Dr. Stephanie Gray 50:39

So also, we mentioned you need to find a great surgeon if you're exploring the possibility of having the enemy to surgery, but you also need to find a great physical therapist. Yeah, to do that assessment that you're alluding to. Right. Great. So last few questions here. So how can women with endometriosis or other pelvic pain conditions just optimize their overall health? For even for healthy sexual relationships?

Yeah, I mean, I

Dr. Jessica Drummond 51:05

think that's the exact same thing can support the layers of your health, digestive stress, immune health, and then in your relationship, the relationship itself has to be healthy, or at least being healthy. You know, if someone's had severe sexual pain for years, and then all of a sudden, it's like, okay, you're fine. Like, what does that mean? Like, you have to develop a language with your partner very often, when I was doing a lot of in person pelvic physical therapy and have person's partner come in. We'd work on languaging communication, building and different kinds of touching and positioning because it's not all or nothing. It's not like don't touch me for five years. And then Okay, fine, let's have every kind of sex we ever thought of. There's gonna be some, you know, emotional connecting, that needs to happen.

Dr. Stephanie Gray 51:57

Sure. Now are many of these tips that we went over in your book?

Dr. Jessica Drummond 52:02

Yes. And a lot more.

Dr. Stephanie Gray 52:05

Tell us about your book.

Dr. Jessica Drummond 52:06

Yeah. So the the book is called outsmart endometriosis. And I'm happy to give anyone listening to this podcast, a free copy, just go to outsmart endo, calm. And there's lots of tips and summary of what we talked about and even recipes to keep you dairy free and gluten free.

Dr. Stephanie Gray 52:27

Wonderful, very generous offer. So thank you so much. This was very helpful. So sincerest Thank you for coming on the show today and giving us so many strategies and tips for improving the quality of life and those suffering with potential endometriosis or other pelvic pain, just providing us hope that women can get their life back just like I did. So thank you for all you do, and all the advocacy for women suffering with these conditions. Thank you so much for having me. It's been my pleasure. What another wonderful guest who is truly an expert on yet another topic, which I agree with her is so often overlooked. Who would have thought that singing loudly or even taking cold baths could impact our hormones and ultimately our pelvic pain for the better. So please check out Dr. drumlins free book for even more helpful strategies. And please share with those in need, the link will be in the show notes. Be sure to check out my book your longevity blueprint. And if you aren't much of a reader, you're in luck, you can now take my course online where I walk you through each chapter in the book. Plus for a limited time, not only is the course 50% off, but you also get your first consult with me for free. Check this offer out at your longevity blueprint.com and click the course tab. One of the biggest things you can do to support the show and help us reach more listeners is to subscribe to the show. And leave us a rating and review on Apple podcasts or wherever you listen. I read all the reviews and would truly love to hear your suggestions for show topics, guests or how you're applying what you've learned on the show to create your own longevity blueprint. A podcast is produced by the team at counterweight creative. As always, thanks so much for listening and remember, wellness is waiting.

The information provided in this podcast is educational. No information provided should be considered to be or used as a substitute for medical advice, diagnosis or treatment. Always consult with your personal medical authority.